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Open AccessArticle

The Role of Community Pharmacists in the Detection of Clinically Relevant Drug-Related Problems in Chronic Kidney Disease Patients

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Faculty of Pharmacy, Reims University, 51 rue Cognacq-Jay, 51100 Reims, France
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Department of Pharmacy, CHU Reims, Avenue du Général Koenig, 51100 Reims, France
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Pharmacie d’officine Croix du Sud, 13 avenue Léon Blum, 51100 Reims, France
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Union Régionale des Professionnels de Santé (URPS) Pharmacien Grand Est, 18 quai Claude Le Lorrain, 54000 Nancy, France
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General practitioner office, 35 Place Luton, 51100 Reims, France
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Department of Nephrology, CHU Reims, Avenue du Général Koenig, 51100 Reims, France
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Faculty of Medicine, Reims University, 51 rue Cognacq-Jay, 51100 Reims, France
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General practitioner office, 15 Ter rue Charles de Gaulle, 51170 Ville-en-Tardenois, France
*
Authors to whom correspondence should be addressed.
List of the Investigators can be found in the Acknowledgment section.
Pharmacy 2020, 8(2), 89; https://doi.org/10.3390/pharmacy8020089
Received: 15 April 2020 / Revised: 9 May 2020 / Accepted: 21 May 2020 / Published: 22 May 2020
(This article belongs to the Special Issue Pharmacokinetics of Drugs and Dosing in Kidney Disease)
Community pharmacists (CPs) have traditionally had limited access to patients’ estimated glomerular filtration rate (eGFR) during the medication-dispensing process. The increasing access to shared electronic health records is making eGFR available, but the skills needed to detect and manage clinically relevant drug-related problems (DRPs) are poorly documented. The primary objective of this study was to investigate the role of CPs in the medication-dispensation process for elderly patients with renal impairment. A total of 70 CPs participated in this 6 month study. Community pharmacists asked all patients ≥65 years to bring their laboratory test values for the next medication-dispensing process. Drug-related problem detection rates were compared between CPs (prospective period) and expert pharmacists (retrospectively). The clinical relevance of each DRP was assessed by nephrologists and general practitioners using an appropriate tool. Community pharmacists recruited n = 442 patients with eGFR < 60 mL/min/1.73 m2 and detected n = 99 DRPs, whereas expert pharmacists detected n = 184 DRPs. The most frequently detected DRPs were dosage problems and contraindications. According to assessment by clinicians, CPs and expert pharmacists identified 54.0% and 84.7% of clinically relevant DRPs, respectively. This study suggests a positive impact of the systematic availability of eGFR to CPs on the detection of several DRPs with clinical relevance. View Full-Text
Keywords: chronic kidney disease; drug-related problems; community pharmacist; estimated glomerular filtration rate chronic kidney disease; drug-related problems; community pharmacist; estimated glomerular filtration rate
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    Description: Table S1: Assessment of the clinical relevance of pharmacist interventions (Tool: modified Chedru) Table S2: Most frequently prescribed medicines (n = 4508 prescribed medicines) Table S3: Cross-assessment of the clinical relevance of DRPs performed by community and expert pharmacists
MDPI and ACS Style

Mongaret, C.; Aubert, L.; Lestrille, A.; Albaut, V.; Kreit, P.; Herlem, E.; Noel, N.; Touré, F.; Lallier, F.; Slimano, F.; MIRPhO Investigators Study, T. The Role of Community Pharmacists in the Detection of Clinically Relevant Drug-Related Problems in Chronic Kidney Disease Patients. Pharmacy 2020, 8, 89.

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